Study: Orthopedics Still Slow to Attract Female Residents

Despite the rising number of female medical students, a new study shows the percentage of women in orthopedics has increased at a statistically lower rate in the United States compared to other medical specialties, though some regions—including the Pacific West and South Atlantic—showed notable growth in attracting practicing female surgeons.

The percentage of female orthopedic residents has gradually increased from 0.6% in 1970 to 20.3% in 2023, according to the American Association of Medical Colleges. While this study demonstrates a national increase in the percentage of female orthopedic surgeons entering the workforce from 2018 to 2023—a trend that is expected to continue—this growth remains slower compared to other surgical specialties. It also highlights the need for additional efforts to recruit female talent to orthopedics, the American Academy of Orthopaedic Surgeons (AAOS) asserts.

The retrospective review used data from the Centers for Medicare & Medicaid Services (CMS) database to examine the number of practicing female orthopedic Medicare providers and patient caseloads. The number of practicing orthopedic surgeons in the data set averaged 23,682 annually across the six-year period. The CMS data was also queried to identify surgical and non-surgical medical specialties including general surgery, obstetrics and gynecology, internal medicine and family medicine, urology and anesthesiology for comparison.

Highlights of the findings include:

• The mean percentage of female orthopedic surgeons across all states was 6.02% in 2018 and demonstrated subsequent annual increases up to 7.51% in 2023, with an overall increase of 1.49% over the six-year period. This value was statistically significantly lower when compared to female growth in other surgical specialties such as general surgery (5.50%) and obstetrics and gynecology (6.93%).
• Percentages of female orthopedic CMS providers also varied by state with a minimum of 0% in Alaska up to a maximum 16.5% for Hawaii in the 2023 data set. A geographical trends analysis revealed a 14% and 23% increase respectively in female orthopedic representation in the Pacific West and South Atlantic regions from 2018 to 2023. These regions demonstrated the highest growth rates for all female providers across the various surgical and non-surgical specialties included in the comparison.
• Caseload per orthopedic CMS provider per state ranged from an average of 2,264 in 2018 to a peak of 2,424 in 2022.
• The study’s limitations highlight that information was restricted to CMS providers, which does not capture all practicing U.S. orthopedic surgeons. However, this population represents a large proportion of orthopedic surgeons; thus, it presents a “worst-case” scenario, as previous studies have speculated that gender disparity may be higher in orthopedic arthroplasty specialists when compared to other orthopedic subspecialties.

With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS advances musculoskeletal health, providing comprehensive education to help orthopedic surgeons and allied health professionals best treat patients. The AAOS is the source of information on bone and joint conditions, treatments, and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.